Cleidocranial Dysplasia: A Rare Case Report.

Cleidocranial dysplasia (CCD) is a rare hereditary disease of unknown etiology which was previously known as cleidocranial dysostosis. It usually follows an autosomal dominant mode of transmission with no predilection of genre or ethnic group. It is caused by a mutation of RUNX2, characterized by generalized dysplasia of the bones and teeth. Affected individuals have short stature, atypical facial features, and skeletal anomalies affecting mainly the skull and clavicle. The dental manifestations are mainly delayed exfoliation of the primary teeth and delayed eruption of the permanent teeth, with multiple impacted supernumeraries, and the absence of cellular cementum. The frequency of this disorder is 1 per million individuals. Here we report a rare case of CCD in a 23 year old female patient having most of the characteristic features of this syndrome.

Effect of PEGylation on drug uptake, biodistribution, and tissue toxicity of efavirenz-ritonavir loaded PAMAM G4 dendrimers.

The present investigations aimed to compare the efficiency of PAMAM G4 (PG4) and PEGylated PAMAM G4 (PPG4) dendrimers as novel nanocarriers for the treatment of HIV-1. Synthesized PG4 and PPG4 dendrimers were confirmed by electrospray ionization and particle size with its morphology. The anti-human immunodeficiency virus (HIV) drug efavirenz (EFV) with a booster dose of ritonavir (RTV) was encapsulated into PG4 and PPG4 formerly noted as PG4ER and PPG4ER, respectively. Further, evaluated for dendrimers mediated solubilization, drug release, cytotoxicity, drug uptake, plasma, and tissue pharmacokinetics, and histopathology. PG4ER and PPG4ER both promoted a prolonged release of EFV in weakly acidic pH 4 up to 84 h and 132 h, respectively. The results of the cytotoxicity assay and drug uptake study showed that PPG4ER was safe and biocompatible up to 12.5 µg/ml. The plasma pharmacokinetic profile of EFV and RTV was significantly increased by PPG4ER with prolonged t1/2 up to three times as compared to free EFV-RTV and PG4ER. Histopathological analysis showed remarkably lower tissue toxicity in PPG4ER as compared to free EFV-RTV. Therefore, overall data suggested that PPG4 has a great potential for prolonged release of EFV and RTV with enhanced bioavailability and lower toxicity.

Role of Saliva as a Non-Invasive Diagnostic Method for Detection of COVID-19.

SARS coronavirus2 is the primary cause of new Coronavirus illness (COVID-19) (SARS- COV-2). Today, COVID-19 is a global epidemic. Coronavirus illness may be diagnosed using a variety of approaches. The gold standard is RT-PCR, which is used in all of these assays. Swabs from the nose, pharynx, or mouth are the most often used sampling methods for coronavirus detection. For COVID-19 testing, saliva may be utilized as an alternate sample. When compared to a nasopharyngeal swab, saliva samples have a number of advantages and disadvantages. Saliva has also been reviewed as a non-invasive diagnostic tool for the detection of COVID-19. The affordability of the salivary diagnostic process makes it an effective process for detecting the COVID-19 viruses. The researchers have found that salivary diagnostic processes have greater chances of success than other processes of Coronavirus detection. However, healthcare professionals need to make positive changes to their working processes to ensure the sustainability of the salivary diagnosis processes.

Insights from Surgically treated Post Covid Acute Invasive Fungal Rhino-Orbital sinusitis in Chandrapur Study (SPAROS): A Population Based study of Coronavirus Associated Mucormycosis (CAM) characteristics in India.

Introduction: Coronavirus disease 2019 (COVID-19)-associated mucormycosis (CAM) became a public health problem in India in 2021. However, information about the incidence, presentation and prognosis of CAM remains sparse. Methods: This study describes 100 cases from the Surgically treated Post COVID Acute invasive fungal Rhino-Orbital Sinusitis in Chandrapur (SPAROS) study, a prospective observational follow-up study of patients with CAM diagnosed in Chandrapur district, India. Two-step cluster analysis using four input variables - blood glucose on admission, diabetes status, glucocorticoid exposure and severity of COVID-19 - was used to define three distinct CAM clusters. Results: The incidence of CAM in the general population was 7.1 cases/1000 patients hospitalized with COVID-19. Steroid exposure and pre-existing diabetes were present in 76% and 55% of cases, respectively. At median follow-up of 18 days, only two deaths had been recorded, while 93 cases were stable. Glucocorticoids, particularly methylprednisolone, seemed to precipitate CAM. Admission to the intensive care unit appeared to be predictive of less extensive surgery. Discussion: Three subtypes of CAM were identified: COVID-19-associated diabetes and mucormycosis, COVID-19-associated classical mucormycosis, and COVID-19-induced mucormycosis. A CAM hypothesis was proposed based on the dynamics of severe acute respiratory syndrome coronavirus-2 and glucose regulated protein. Conclusion: The clinical characteristics, natural course and pathogenesis of CAM differ from mucormycosis in the pre-COVID era. It is hoped that this classification will be useful in CAM management.

Darier disease: A rare genodermatosis.

Darier disease (DD), also known as keratosis follicularis or dyskeratosis follicularis, is a rare autosomal dominant genodermatosis with high penetrance and variable expressivity. It is caused by mutations of ATP2A2 gene which encodes the sarco/endoplasmic reticulum Ca2+ ATPase isoform 2. It is clinically manifested by hyperkeratotic papules primarily affecting seborrheic areas on the head, neck and thorax, with less frequent involvement of the oral mucosa. When oral manifestations are present, they primarily affect the palatal and alveolar mucosa, are usually asymptomatic and are discovered in routine dental examination. Histologically, the lesions show suprabasal clefts with acantholytic and dyskeratotic cells. We present a case of 35-year-old female patient with typical clinical and histological features of DD.

Effect of various temperatures on restored and unrestored teeth: A forensic study.

BACKGROUND: In large scale disasters associated with fire the damage caused by heat can make medico legal identification of human remains difficult. Teeth, restorations, and prostheses all of which are resistant to quite high temperatures and can be used as aids in identification process. AIM: Aim of the study was to investigate the macroscopic and microscopic changes of teeth and several dental filling materials exposed to a range of high temperature (200-800°C). Dental restorations include filling materials, crown, and bridges. MATERIALS AND METHODS: Restored and unrestored teeth were placed in a furnace and heated at a rate of 30°C/min and the effects of the predetermined temperatures 200, 400, 600, and 800°C were observed. Macroscopic and stereo microscope findings were observed. RESULTS: Our results showed that teeth and restorative materials resist higher temperatures than theoretically predicted and that even when a restoration is lost because of detachment or change of state, its ante-mortem presence can be confirmed and detected by stereo microscopic examination of the residual cavity. CONCLUSION: We further conclude that a reasonably reliable estimation of the temperature of exposure can be made from an analysis of the teeth and restorative materials.

Granular cell tumor of the tongue: Report of a case.

Granular cell tumor (GCT) is a benign lesion characterized by the accumulation of plump cells with abundant granular cytoplasm. The formation of a granular cell tumor is a neoplastic process and the lesions formed are of neural derivation, as supported by immunophenotypic and ultra structural evidence. This type of tumor has been found to be both benign and malignant although malignancy is rare and comprises only 2% of all granular cell tumors. Here we report a case of GCT in a 40 year old male patient on the posterolateral border of tongue.

Unusual intramaxillary plexiform schwannoma.

BACKGROUND: Neoplasms of peripheral nerve in the head and neck region are of common occurrence, but origin in the oral and para-oral tissues is uncommon and they rarely occur centrally within the jaws. Schwannoma is a benign neoplasm originating from the neural sheath of peripheral soft tissues, but its occurrence within the jaw bones is most unusual. Plexiform schwannoma is a unique variant of Schwann cell tumours having plexiform pattern. Literature revealed only one case of plexiform schwannoma of the jaw bones, i.e. involving the mandible. CASE REPORT: In this report, we present the first documented case of intraosseous plexiform schwannoma of the maxilla, an extremely rare benign neurogenic tumour treated surgically. DISCUSSION: Schwannoma is a benign neoplasm originating from the neural sheath of peripheral soft tissues, but to occur within the jaw bones is exceptional. Plexiform schwannoma is a rare variant of Schwann cell tumour having plexiform pattern of intraneural growth with multinodularity. Plexiform schwannoma is a benign neoplasm with no malignant potential, but recurrences are evident if excised incompletely. Plexiform schwannoma has similar clinical and histopathological features as that of plexiform neurofibroma which has high malignant potential; hence, it is imperative to correctly diagnose and differentiate this lesion as treatment modality of these two lesions differs.

Odontoameloblastoma.

Odontoameloblastoma (OA) is an extremely rare mixed odontogenic tumor with both epithelial and mesenchymal components. OA develops from proliferating odontogenic epithelium and mesenchymal tissue. Till date, around 20 cases have fulfilled the histologic criteria of the current World Health Organization (WHO) histologic classification of odontogenic tumors. It affects predominantly young patients with a median age of 20.12 years, and has a predilection for males and occurs in posterior segments of either jaw with slight inclination for mandible. Review of literature shows only three reported cases in the anterior mandible. Here, we report a case of OA in the anterior mandible.